Pediatric anxiety disorders, from preschool through adolescence, are prevalent, impairing, and associated with increased risk for depression and anxiety disorders in adulthood. We propose a longitudinal, cohort study of children diagnosed with three common anxiety disorders: social phobia (SoPh), separation anxiety disorder (SAD), and/or generalized anxiety disorder (GAD) as preschoolers (ages 2-5). We will employ functional magnetic resonance imaging (fMRI), and eye tracking to characterize the development and to identify the neural basis of deficits in emotion processing and social perception in young children diagnosed with these early onset anxiety disorders. We will recruit 180 subjects (120 with SAD, GAD and/or SoPh; 60 with no psychiatric disorder as preschoolers) one year after they participate in a current NIMH funded, cross-sectional study of preschool anxiety disorders in a representative sample of children recruited from pediatric primary care. The children will be followed annually across five years of data collection. Our aims are: (1) Identification of dysfunctions of the neural circuitry involved in emotion processing in children with preschool SAD, SoPh, and GAD (2) Examination of the mechanisms underlying the persistence and development of functional abnormalities in the neural circuitry involved in emotion processing in children with preschool SoPh, GAD, and SAD. PUBLIC HEALTH RELEVANCE: This proposed study has the potential to make substantial contributions to our understanding of the nature and development of the brain: behavior relationship in children with early onset anxiety disorders. It would also be the first longitudinal study of a representative sample of typically developing children using imaging and eye tracking approaches. This work will contribute to our understanding of early childhood mental health disorders and lead toward the development of reliable treatments and preventive interventions for young children with impairing anxiety.